TO: __________________________
__________________________
Since receiving the ___________________________
issued under the number ________________________,
it has been stolen. The card was stolen on or about
______________, 20______.
The card was stolen under the following circumstances:
(Describe Situation)
I notified ______________________________ by telephone
of the theft of the card on _______________________,
20______.
You are hereby authorized to take all steps necessary
and to notify the appropriate authorities to avoid
illegal use of the above-numbered credit card.
______________________________
NOTICE
The information in this document is designed to
provide an outline that you can follow when formulating
business or personal plans. Due to the variances of
many local, city, county and state laws, we recommend
that you seek professional legal counseling before
entering into any contract or agreement.
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